title: Prolonged improvement after rituximab: two cases of resistant muscle-specific receptor tyrosine kinase + myasthenia gravis.
abstract: Forty percent to 50% of acetylcholine receptor antibody-seronegative patients with myasthenia gravis have muscle-specific receptor tyrosine kinase antibodies. Many muscle-specific receptor tyrosine kinase + myasthenia gravis patients remain refractory with conventional therapies. Rituximab is an anti-CD20 monoclonal antibody used in refractory B-cell disorders. Currently there is no standard dosing schedule for rituximab. We present two muscle-specific receptor tyrosine kinase + myasthenia gravis patients clinically refractory to conventional therapy who, after a single course of rituximab, became asymptomatic and discontinued all medication.
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Prinyarat
authors.initials: P
authors.lastname: Burusnukul
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Brennan
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Cupler
mesh_terms: D000293:Adolescent; D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage* / Q000009:adverse effects; D001323:Autoantibodies / Q000096:biosynthesis*; D004351:Drug Resistance / Q000276:immunology; D005260:Female; D006801:Humans; D009157:Myasthenia Gravis / Q000201:enzymology / Q000276:immunology* / Q000628:therapy*; D020794:Receptor Protein-Tyrosine Kinases / Q000276:immunology*; D011950:Receptors, Cholinergic / Q000276:immunology*; D020127:Recovery of Function / Q000276:immunology; D000069283:Rituximab; D013995:Time; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D011950:Receptors, Cholinergic; D000069283:Rituximab; C095714:MUSK protein, human; D020794:Receptor Protein-Tyrosine Kinases